IBD in the elderly population: results from a population-based study in Western Hungary, 1977-2008.

ABSTRACT

BACKGROUND AND AIMS: Limited data are available on the incidence and disease course of IBD in the elderly population. Our aim was to analyze the incidence and disease course of IBD according to the age at diagnosis in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008. METHODS: Data of 1420 incident patients were analyzed (UC 914, age at diagnosis 38.9 SD 15.9 years; CD 506, age at diagnosis 31.5 SD 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. RESULTS: 106 (11.6%) of UC patients and 21 (4.2%) of CD patients were diagnosed with >60 years of age. In UC, the incidence increased from 1.09 to 10.8/10(5) in the elderly, while CD increased to 3.04/10(5) in 2002-2007. In CD, colonic location (elderly 61.9% vs. pediatric 24.3%, p=0.001, and adults 36.8%, p=0.02) and stenosing disease (elderly 42.9% vs. pediatric 14.9%, p=0.005, and adults 19.5%, p=0.01) were more frequent in the elderly. A change in disease behavior was absent in the elderly, while in pediatric and adult CD population it was 20.3% (p=0.037), 19.8% (p=0.036) after 5 years. In UC, extensive disease was more frequent in pediatric patients compared to the elderly (p=0.003, OR 2.73, 95%CI 1.38-5.41). In addition, pediatric (57.3%, p<0.001, OR 6.58; 95%CI 3.22-12.9) and adult (39.8%, p<0.001, OR 3.24; 95%CI 1.91-5.49) patients required more often systemic steroids during follow-up compared to the elderly (17%). Proximal extension at 10 years was 11.6%, but time to extension was not different according to the age at onset. CONCLUSIONS: Elderly patients represent an increasing proportion of the IBD population. Stenosing and colon-only disease were characteristic for elderly CD patients, while the disease course in UC was milder.